Ci)e  Hibtarp 

of  t|)e 

Obtston  of  ^ealtb  affairs 
Slnit)et0itp  of  iSottii  Carolina 


TO.  ^iW. 


A 


Ifi&IM. 


x 


Digitized  by  tine  Internet  Arcliive 

in  2009  witli  funding  from 

Nortii  Carolina  History  of  Health  Digital  Collection,  an  LSTA-funded  NC  ECHO  digitization  grant  project 


http://www.archive.org/details/proceedingsofstaOOmedi 


PROCEEDINGS 


OF    THE 


STATE    MEDICAL    COiNVENTION, 


HELD  IN  RALEIGH,  APRIL,  1849. 


AISID 


CONSTITUTION   AND   MEDICAL   ETHICS, 


OF 


THE  MEDICAL  SOCIETY 


OF    THE 


STATE   OF  NORTH  CAROLINA, 


THEN   ADOPTED. 


RALEIGH,  N.  C. 
PUBLISHED  BY  ORDER  OF   THE  CONVENTION. 

VV.   W.  HOI.DEN,   Printer. 

1849. 


ADDRESS 

TO  THE  PHYSICIANS  OF  NORTH  CAROLINA. 


Gentlemen  and  Brethren  of  the  Medical  Profession :  A 
notice  was  published  the  7th  day  of  February  last  requesting 
that  a  Convention  of  Physicians,  from  the  different  portions  of 
this  State,  should  be  held  in  Raleigh,  on  the  16th  of  April,  1849, 
for  the  purpose  of  organizing  a  Medical  Society  of  the  State  of 
North  Carolina. 

The  hopes  of  those  who  issued  this  publication  were  disap- 
pointed when  that  day  brought  to  the  designated  place  a  delega- 
tion incompetent  in  numbers  perhaps,  but  not  in  spirit,  we  trust, 
to  represent  fairly  your  honorable  body. 

This  mortifying  circumstance  influenced  for  a  while  some  of 
the  most  elevated  and  liberal  minds  amongst  us  against  the  as- 
sumption of  the  name  and  authority  of  a  State  Convention ; 
but  a  more  correct  opinion,  and  one  more  flattering  to  you, 
finally  prevailed ;  which  was,  that  as  this  Convention  should 
dictate  to  no  one,  but  proceed  to  organize  a  Society  for  the  ad- 
vancement of  Medical  Science  and  the  elevation  of  our  profes- 
sional standard  upon  those  honorable  principles  which  have 
already  been  adopted  by  distinguished  characters,  whom  you 

profess  to  admire,  it  would  at  once  receive  your  unqualified 
support. 

The  proceedings  of  this  Convention  and  of  the  Society, 
which  it  has  formed,  are  laid  before  you  in  the  following  pages, 
and  we  invite  you  to  the  positions  there  taken.  We  appeal  to 
you,  in  a  fraternal  spirit,  to  co-operate  with  us  in  maintaining 
those  positions;  for  every  educated  physician  in  the  State  ac- 
knowledges with  the  deepest  regret  that  under  the  combined 
operations  of  corrupt  influences  our  honorable  profession  has 


been  injured  in  its  standing— our  titles  are  assumed  and  our 
privileges  claimed  by  charlatans  of  every  cast. 

Will  you  then  join  us  in  exposing  the  impertinence  of  the  as- 
sumption, and  the  dishonesty  of  the  claim,  and  by  the  unani- 
mous adoption  of  the  provisions  here  respectfully  submitted  to 
your  consideration,  come  out  in  organized  bodies  and  unite  with 
the  Medical  Society  of  the  State  of  North  Carolina,  where  your 
true  character  will  appear  in  its  code  of  ethics,  and  the  hue  of 
science  once  more  shine  on  your  tarnished  escutcheon?  We 
believe  you  will. 

This  appeal,  we  wish  it  distinctly  to  be  understood,  is  ad- 
dressed to  every  gentleman  in  the  practice  of  Medicine,  whether 
a  graduate  or  not,  who  feels  in  his  own  bosom  a  response  to  its 
truth,  its  justice,  and  its  necessity. 

We  are  calling  for  a  spirit  of  improvement;  let  him  answer 
who  has  it.  The  general  qualifications  for  membership  in  the 
County  Associations  and  for  delegates  to  the  State  Society,  we 
believe  can  offend  no  man  who  has  that  elevated  spirit ;  and 
others  you  will  willingly  leave  on  that  degraded  level  from 
which  we  exhort  you  to  depart  with  us. 

J.  B.  JONES,  M.  D. 

W^  H.  McKEE,  M.  D. 

N.  J.  PITTMAN,  M.  D. 

J.  A.  McRAE,  M.  D. 

R.  B.  HAYWOOD,  M.  D. 


5 

MINUTES  OF  THE  PROCEEDINGS 

OF    THE 

MEDICAL  CONVENTION  OF  N.  CAROLINA, 

HELD 

L\  RALEIGH,  APRIL,  1819. 


RALEIGH,  April  16,  1849. 

In  pursuance  of  a  call  upon  the  profession,  made  by  the  Phy- 
sicians in  attendance,  and  members  of  the  Legislature,  at  its  last 
session,  and  those  of  this  City,  with  several  others  from  the 
different  Counties,  we,  a  portion  of  the  profession,  representing 
different  sections  of  the  State,  assembled  in  obedience  to  the 
call,  in  the  Supreme  Court  Room  of  the  Capitol,  at  8  o'clock 
P.  M.  for  the  purpose  of  forming  a  State  Medical  Society  for  the 
State  of  North  Carolina ;  when 

Dr.  Edmund  Strudwick,  of  Orange,  moved  that  the  Conven- 
tion be  organized  by  appointing  Dr.  Frederick  J.  Hill,  of  Bruns- 
wick, President;  and  on  motion  of  Dr.  James  E.  Williamson, 
of  Caswell,  Dr.  WiUiam  H.  McKee,  of  Wake,  was  appointed 
Secretary. 

On  motion  of  Dr.  Strudwick,  the  sense  of  the  Convention 
was  now  taken  upon  the  formation  of  a  Medical  Society  for  the 
State  of  North  Carolina,  and  decided  in  the  affirmative.  It  was 
also  further  moved  that  a  Commitee  of  two  be  appointed  to 
ascertain  the  number  of  Counties  represented,  and  to  report 
them,  with  the  names  of  Delegates.  Doctors  Strudwick  and 
McKee  were  appointed  said  Committee,  and  made  the  following 
report : 


namp:s  of  the  physicians  in  attendance. 


BRUNSWICK    COUNTY. 

Frederick  J.  Hill. 


ORANGE. 


Edmund  Strudwick, 
Thomas  H,  Turner, 
William  Webb. 

Fabius  J.  Haywood, 
William  H.  McKee, 
N.  L.  Stith, 
David  A.  Telfair, 
A.  H.  Taylor, 
L.  C.  Manly, 
R.  B.  Haywood. 


WAKE. 


Walter  A.  Norwood, 
Johnston  B.  Jones, 


Charles  E.  Johnson, 
William  G.  Hill, 
Henry  Sea  well, 
J.  B.  Dunn, 
Wm.  M.  Crenshaw, 
Jos.  J.  W.  Tucker, 


CASWELL. 

James  E.  Williamson, 


James  A,  McRae. 
N.  J.  Pittman, 
Nereus  Mendenhall. 


CUMBERLAND. 


EDGECOMB. 


William  G.  Thomas. 


GUILFORD. 


LINCOLN. 

Henry  W.  Graham. 
On  motion  of  Dr.  McRae,   a  Committee  of  one  from  each 
County  was  appointed  to  draft  a  Constitution  and  By-Laws  for 
the  government  of  the  Society,  with  instructions  to  report  at  the 
next  Meeting.     Committee: 

James  E.  Williamson,  of  Caswell, 
Edmund  Strudwick,     "   Orange, 
James  A.  McRae,  "   Cumterland, 

Newsom  J.  Pittman,      "  Edgecomb, 
Henry  W.  Graham,        "  Lincoln, 
Richard  B.  Haywood,    "  Wake, 
Nereus  Mendenhall,       '-   Guilford. 
On  motion  of  Dr.  R.  B.  Haywood,  the  Convention  adjourned 
to  meet  at  10  o'clock.  A.  M. 


TUESDAY  MORNING,  April  IT,  1840. 

The  Convention  re-assembled  at  10  o'clock,  A.  M. 

The  Minutes  of  the  first  day^s  proceedings  Avere  read  and 
adopted. 

The  President  laid  before  the  Convention  a  letter  that  he  had 
just  received  from  Dr.  T.  N.  Cameron,  of  Cumberland,  which 
was  ordered  to  be  read ;  in  which  he  expressed  his  regrets  in 
not  being  able  to  attend  upon  the  deliberations  of  the  Conven- 
tion, but  Avould  heartily  co-operate  with  the  members  in  carry- 
ing out  the  designs  of  the  Society. 

The  Committee  appointed  to  report  a  Constitution  and  By- 
Laws  for  the  government  of  the  Convention,  submitted  a  copy 
of  each,  through  their  chairman,  Dr.  J.  E.  Williamson. 

On  motion  of  Dr.  Johnson,  the  Secretary  was  instructed  to 
first  read  the  Constitution  as  reported ;  after  the  reading  of  which, 
it  was  read  again,  each  article  separately,  and  amended,  and,  as 
amended,  adopted  as  a  whole. 

Dr.  Norwood  moved  that  the  Convention  do  now  adjourn, 
and  resolve  itself  into  a  Medical  Society  for  the  State  of  North 
Carolina,  and  that  the  officers  of  the  Convention  be  requested 
to  act  as  the  officers  of  the  Society,  until  the  regular  officers  of 
the  Medical  Society  shall  be  elected  and  installed.  The  Con- 
vention then  adjourned,  and  the  officers  took  their  seats  as  the 
officers  of  the  Medical  Society.  The  President  then  announced 
the  Society  ready  to  receive  nominations  for  permanent  officers. 

The  following  named  gentlemen  were  declared  duly  elected 
for  one  year,  they  having  no  regular  opposition : 

PRESIDENT. 
DR.  EDMUND  STRUDWICK,  of  Orange. 

VICE  PRESIDENTS. 

Dr.  Fabius  J.  Haywood,      ?      .  Raleigh, 

"  Charles  E.  Johnson,    )     ^ 

"  James  E.  Williamson,  of  Caswell. 

<'  William  G.  Thomas,  of  Edgecomh. 

COR.  AND  REC.  SECRETARY. 
Dr.  William  H.  McKee,  of  Raleigh. 

TREASURER. 
Dr.  William  G.  Hill,  of  Raleigh. 


8 

The  President  was  then  conducted  to  the  Chair,  and  returned 
his  thanks  in  an  appropriate  manner  for  the  honor  conferred  upon 
him,  by  selecting  him  to  preside  over  the  dehberations  of  the 
first  Medical  Society  within  the  State,  and  pledged  himself  to 
exert  his  best  efforts  to  promote  its  objects. 

Dr.  McKee  introduced  the  following  Resolution,  which  was 
unanimously  adopted : 

Resolved^  That  the  thanks  of  this  Society  are  due,  and  are 
hereby  tendered  to  Dr.  Frederick  J.  Hill,  for  the  dignified  and 
impartial  manner  in  which  he  has  presided  over  the  delibera- 
tions of  the  late  State  Medical  Convention. 

Dr.  Williamson  moved  that  the  Constitution  as  amended'and 
adopted  by  the  late  Convention,  now  be  adopted  as  the  Consti- 
tution of  the  Medical  Society  of  the  State  of  North  Carolina ; 
which  was  agreed  to. 

On  motion  of  Dr.  Jones,  the  By-Laws,  as  reported  by  the 
Committee,  were  read;  after  which  they  were  unanimously 
adopted. 

Dr.  Jones  moved  that  a  Committee  of  five  be  appointed  to 
draft  an  address  to  the  Medical  Profession  of  the  State,  and  to 
aid  in  drawing  up  the  proceedings  of  the  Convention  and  So- 
ciety for  publication.  Adopted— and  Drs.  Jones,  McKee,  Pitt- 
man,  R.  B.  Haywood,  and  McRae  were  appointed  said  committee. 

On  motion  of  Dr.  Norwood,  a  committee  was  appointed  con- 
sisting of  Drs.  Norwood  and  Jones  to  report  the  amount  of 
funds  necessary  to  defray  the  expenses  of  the  Convention  and 
Society,  and  to  assess  each  member  accordingly.  The  commit- 
tee reported  that  three  dollars  a  piece  would  be  amply  sufficient 
to  defray  all  the  expenses  of  the  Convention  and  Society. 

Dr.  Thomas  moved  that  the  Secretary  be  instructed  to  for- 
ward to  the  Editor  of  the  American  Journal  of  Medical  Science, 
a  copy  of  the  proceedings  of  the  Convention  and  Society  for 
publication ;  and  that  the  Editors  of  the  newspapers  through- 
out the  State  be  requested  to  publish  the  proceedings. 

Dr.  Williamson  moved  that  the  committee  appointed  to  report 
a  Constitution  &c.,  for  the  government  of  the  Society,  be  con- 
tinued and  instructed  to  report  a  Code  of  Medical  Ethics  for  tlie 
Profession  at  the  next  meeting  of  the  Society. 

On  motion  of  Dr.  Johnson,  the  Society  adjourned  to  meet 
again  at  5  o'clock.  P.  M. 


AFTERNOON  SESSION,  5  o'clock,  P.  M. 

The  Minutes  of  this  morning's  proceedings  were  read  and 
approved. 

Dr.  T.  N.  Cameron,  of  Cumberland,  appeared  and  took  his 
seat  as  a  member  of  the  Society. 

The  committee  reported  the  Code  of  Ethics  as  adopted  by 
the  American  Medical  Association,  with  the  exception  of  that 
portion  which  says:  "In  obstetrical  and  important  surgical  cases 
which  give  rise  to  unusual  fatigue,  anxiety  and  responsibility,  it 
is  just  that  the  fees  accruing  therefrom  should  be  awarded  to 
the  physician  who  officiates;"  which  was  adopted  unanimously. 

The  committee  on  unfinished  business  reported  the  names  of 
Dr.  Thos.  N.  Cameron,  Newsom  J.  Pittman,  and  Johnston  B. 
Jones,  as  Delegates  to  the  American  Medical  Association  in 
Boston  in  May  next — and  Dr.  James  A.  McRae,  William  G. 
Thomas,  and  Richard  B.  Haywood,  alternates. 

The  committee  also  recommended  the  first  Wednesday  in 
April,  1850,  as  the  next  time  of  meeting  of  the  Society ;  and 
that  the  Society  shall  meet  in  Raleigh. 

On  motion  of  Dr.  McKee,  Dr.  T.  N.  Cameron  was  appointed 
to  deliver  an  address  before  the  next  meeting  of  the  Society  on 
some  Medical  subject,  to  be  selected  by  himself;  and  Dr.  C.  E. 
Johnson  was  appointed  his  alternate. 

On  motion  of  Dr.  Johnson,  Dr.  F.  J.  Hill,  of  Brunswick,  was 
unanimously  elected  an  honorary  member  of  this  Society,  and 
the  Secretary  was  instructed  to  communicate  the  same  to  him. 

On  motion  of  Dr.  N.  J.  Pittman,  the  Society  adjourned  to 
meet  again  in  the  City  of  Raleigh,  on  the  first  Wednesday  in 
April,  1850. 

EDMUND  STRUDWICK,  M.  D.,  President. 

W.  H.  McKee,  M.  D.,  Secretary. 


10 

CONSTITUTION 

OF   THE 

MEDICAL  SOCIETY  OF  THE  STATE  OF  NORTH  CAROLINA, 

Adopted  April  17,  1849. 


ARTICLE  L 

Title  of  the  Society. 

The  name  and  title  of  this  Society  shall  be  "  The  Medical 
Society  of  the  State  of  North  Carolina." 

ARTICLE  II. 
Objects  of  the  Society. 

The  objects  of  this  Society  shall  be  the  advancement  of  Medi- 
ical  knowledo^e,  the  elevation  of  professional  character,  and  the 
promotion  of  all  measures  of  a  professioncil  nature  that  are  adap- 
ted to  the  relief  of  suffering  humanity,  and  to  improve  the  health 
and  protect  the  lives  of  the  community. 

ARTICLE  IIL 
Members  of  the  Society. 

Sec.  1.  The  Society  shall  consist  of  Delegates  and  Associ- 
ates. 

Sec  2.  The  Delegates  shall  receive  their  appointment  from 
the  County  Societies,  and  from  the  Counties  that  have  no  Soci- 
eties a  Delegate  may  be  appointed  by  the  profession  of  the 
County :  Provided,  that  they  have  as  many  as  two  regular 
practitioners  within  the  County. 

Sec.  3.  Every  Delegate,  before  admission  to  a  seat  in  the 
Society,  shall  produce  a  certificate  of  delegation,  signed  by  the 
President  or  Secretary  of  his  County  Society  or  Association,  and 
shall  sign  the  Constitution  and  pay  the  assessment. 

Sec.  4.  Each  Delegate  shall  hold  his  appointment  for  one 
year,  or  until  another  is  appointed  to  succeed  him. 

Sec.  5.  Every  member  of  a  County  Society  shall  bean  As- 
sociate of  the  State  Medical  Society,  so  long  as  he  conforms 
to  its  regulations  ;  and  in  case  there  be  no  Medical  Society  or 
Association  in  any  County,  and  a  member  of  the  profession  of 
acknowledged  character  and  standing  from  such  County  apply 
to  this  Society  to  be  admitted  to  membership,  that  he  be  admitted 
to  all  the  privileges  of  an  associate. 


11 

ARTICLE  IV. 

Of  the  Officers. 

Sec.  1.  The  officers  of  this  Society  shall  be  a  President  and 
four  Vice  Presidents,  a  Corresponding  and  Recording  Secretary, 
and  a  Treasurer. 

Sec.  2.  Each  officer  shall  be  elected  by  vote,  viva  voce,  and 
shall  serve  for  one  year,  or  until  another  is  elected  to  succeed 
him. 

Sec.  3,  None  but  Delegates  shall  be  eligible  to  the  office  of 
President,  Yice  President,  Secretary  or  Treasurer. 

ARTICLE  V. 
Duties  of  Officers. 

Sec.  1.  The  President  shall  preside  at  the  meetings,  preserve 
order,  and  perform  such  other  duties  as  custom  and  parliamen- 
tary usage  may  require.  He  may  be  eligible  for  two  terms  in 
succession. 

Sec.  2.  The  Vice  President,  when  called  upon,  shall  assist 
the  President  in  the  performance  of  his  duties,  and  during  the 
absence  of  or  at  the  request  of  the  President,  one  of  them  shall 
officiate  in  his  place.  They  shall  be  eligible  two  terms  in  suc- 
cession. 

Sec.  3.  The  Corresponding  and  Recording  Secretary  shall 
conduct  the  correspondence,  and  perform  such  other  duties  as 
usually  appertain  to  that  office ;  and  shall  keep  correct  minutes 
of  the  proceedings  of  the  Society,  and  shall  fairly  transcribe  the 
same,  when  approved,  in  a  book,  to  be  kept  for  the  purpose. 
He  shall  have  charge  of  all  papers  belonging  to  the  Society, 
other  than  those  appertaining  to  the  Treasurer ;  and  shall  give 
due  notice  of  the  annual  meetings,  and  he  shall  receive  such 
compensation  as  the  Society  may  from  year  to  year  determine. 

Sec.  4.  The  Treasurer  shall  receive  all  monies  belonging  to 
the  Society,  and  disburse  them  as  directed,  preserving  vouchers 
for  the  same.  He  shall  annually  present  a  statement  of  the 
finances  of  the  Society,  which  shall  be  referred  to  a  Committee 
of  the  Delegates,  to  be  audited. 

ARTICLE  VI. 
Of  the   County  Societies. 

Sec.  1.  The  members  of  the  Profession  in  any  County  of 
this  State,  who  form  themselves  into  a  County  Society,  may 
become  auxiliary  to  this  Society  :  Provided,  that  all  the  regu- 
lar practitioners  in  the  County  ha\'e  been  invited  to  unite  in  its 


12 

orgaiiizatioiij  and  provided^  that  the  constitution  and  hiws  of 
such  Society  do  not  contravene  those  of  the  State  Society. 

Sec.  2.  No  one  shall  be  admitted  as  a  member  of  the  County 
Society,  unless  he  is  either  a  graduate  in  Medicine  of  some  res- 
pectable Medical  School,  or  has  been  a  practitioner  for  at  least 
five  years ;  and  who,  moreover,  is  in  good  moral  and  profession- 
al standing  in  the  place  where  he  resides,  and  is  a  regular  prac- 
titioner. 

Sec.  3.  Any  Physician  who  shall  procure  a  patent  for  a 
remedy,  or  instrument  of  surgery,  or  who  shall  hereafter  give 
a  certificate  in  favor  of  a  patent  remedy,  or  instrument,  shall 
be  deemed  disqualified  from  becoming  a  member  of  a  County 
Society. 

Sec.  4.  As  soon  as  a  County  Society  is  organized,  the  Sec- 
retary thereof  shall  transmit  to  the  Corresponding  and  Record- 
ing Secretary  one  copy  of  the  Constitution  and  By-Laws,  with 
the  name  of  their  officers  and  members.  The  Society  shall  be 
authorized  to  elect  one  Delegate  to  the  State  Society  for  every 
five  of  its  members. 

Sec.  5.  Every  County  Society  shall  enforce  the  observance 
by  its  members  of  the  Code  of  Ethics  adopted  by  the  State  So- 
ciety, and  they  shall  be  authorized  to  censure  or  expel  any 
member  convicted  of  violating  its  provisions. 

Sec.  6.  A  member  of  a  County  Society  who  is  censured  or 
expelled,  shall  have  a  right  to  appeal  to  the  State  Society. 

Sec.  7.  A  member  who  is  expelled,  shall  be  debarred  from 
the  rights  of  consultation,  or  the  privileges  of  Professional  inter- 
course with  any  member  of  the  State  Society. 

Sec.  8.  The  County  Societies  shall  report  annually  to  the 
State  Society  a  list  of  their  officers  and  members,  any  new  rules 
which  they  may  adopt,  and  such  other  matters  as  they  may 
deem  interesting. 

Sec.  9.  The  County  Societies  shall  hold,  at  least,  two  meet- 
nigs  in  each  year. 

Sec.  10.  If  any  County  Medical  Society  shall  neglect  to 
perform  all  such  acts  as  may  be  required  to  be  done  by  the  laws 
of  the  State  Society,  or  shall  be  guilty  of  conduct  derogatory 
to  the  honor  of  the  Medical  Profession,  or  shall  oppose  or  neg- 
lect to  comply  with  the  laws  of  the  State  Society,  such  County 
Society  shall,  during  such  delinquency,  have  their  privileges) 


as  a  portion  of  the  State  Society  suspendedj  and  their  Delegates 
shall  not  be  entitled  to  a  seat  in  the  State  Society. 

ARTICLE   VII. 
Meetings  of  the  Society. 
Sec.  1.     The  Society  shall  hold  an  Annnal  Meeting  in  the 
month  of  April  of  each  year. 

Sec.  2.     The  time  and  place  of  meeting  shall  be  determined, 
for  each  succeeding  year,  by  a  vote  of  the  Society. 

ARTICLE  YIII. 
Of  the  Funds. 
Funds  for   defraying  the   current  expenses  of  the  Society, 
maybe  raised  by  an  assessment  of  the  County  Societies,  to  be 
made  at  the  Annual  Meeting  of  the  State  Medical  Society. 

ARTICLE  IX. 
Code  of  Ethics. 
This  Society  adopts,  as  a  part  of  its  regulations,  that  part  of 
the  Code  of  Ethics  of  the  American  Medical  Association,  which 
it  publishes  by  its  order. 

ARTICLE  X. 
Provisiotis  for  Amendments. 
Every  proposal  for  altering  or  amending  this  Constitution 
shall  be  made  in  writing;  and  if  such  alteration  or  amendment 
receives  the  unanimous  vote  of  the  members  present,  it  shall 
be  adopted ;  but,  if  objections  be  made,  the  alteration  or  amend- 
ment shall  lie  over  until  the  next  Annual  Meeting,  when,  if  it 
receives  the  vote  of  two-thirds  of  the  voters  present,  it  shall  be 
adopted. 


14 
BY-LAWS. 


OF    THE    ORBEIl    OF    BUSINESS. 

1.  The  President,  or  in  his  absence,  the  senior  Vice  Presi- 
dent shall  call  the  Society  to  order ;  or  in  case  of  the  absence 
of  all  these  officers,  a  Chairman  shall  be  appointed  j)To  tern,  for 
the  purpose. 

2.  The  appointment  of  a  Committee  to  examine  the  creden- 
tials oi  Delegates. 

3.  The  report  of  the  above  named  Committee. 

4.  Calling  the  Roll. 

5.  Resolutions  introducing  new  business. 

6.  Reading  the  Minutes. 

7.  Any  business  which  requires  early  consideration  may,  by 
permission,  be  introduced. 

8.  Reports  from  the  County  Societies. 

9.  The  Correspondence  shall  be  read  by  the  Corresponding 
Secretary. 

10.  Written  communications  on  Medical  subjects  may  be 
read  and  discussed. 

11.  Oral  communications  may  be  made  and  discussed. 

12.  Electing  Officers. 

13.  The  selection  of  a  place  for  the  next  Meeting  of  the 
Society. 

14.  Unfinished  and  miscellaneous  business. 


15 

CODE  OP  MEDICAL  ETHICS, 

Adopted  hy  the  American  Medical  Association  and  recognized 
by  the  Medical  Society  of  the  State  of  North  Carolina. 

INTRODUCTION    TO    THE    CODE    OF    MEDICAL    ETHICS. 

Medical  ethics,  as  a  branch  of  general  ethics,  must  rest  on 
the  basis  of  religion  and  moraUty.  They  comprise  not  only  the 
duties,  but  also  the  rights  of  a  physician:  and,  in  this  sense,  they 
are  identical  with  Medical  Deontology — a  term  introduced  by  a 
late  writer,  who  has  taken  the  most  comprehensive  view  of  the 
subject. 

In  framing  a  code  on  this  basis,  we  have  the  inestimable  ad- 
vantage of  deducing  its  rules  from  the  conduct  of  the  many 
eminent  physicians  who  have  adorned  the  profession  by  their 
learning  and  their  piety.  From  the  age  of  Hippocrates  to  the 
present  time,  the  annals  of  every  civilized  people  contain  abun- 
dant evidences  of  the  devotedness  of  medical  men  to  the  relief 
of  their  fellow  creatures  from  pain  and  disease,  regardless  of  the 
privation  and  danger,  and  not  seldom  obloquy,  encountered  in 
return ;  a  sense  of  ethical  obligations  rising  superior^  in  their 
minds,  to  considerations  of  personal  advancement.  Well  and 
truly  was  it  said  by  one  of  the  most  learned  men  of  the  last  cen- 
tury, that  the  duties  of  a  physician  were  never  more  beautifully 
exemplified  than  in  the  conduct  of  Hippocrates,  nor  more  elo- 
quently described  than  in  his  writings. 

We  may  here  remark,  that,  if  a  state  of  probation  be  intended 
for  moral  discipline,  there  is,  assuredly,  much  in  the  daily  life  of 
a  physician  to  impart  this  salutary  training,  and  to  insure  con- 
tinuance in  a  course  of  self-denial,  and  at  the  same  time,  of 
zealous  and  methodical  efforts  for  the  relief  of  the  suffering  and 
unfortunate,  irrespective  of  rank  or  fortune,  or  of  fortuitous  ele- 
yation  of  any  kind. 

A  few  considerations  on  the  legitimate  range  of  medical  ethics 
will  serve  as  an  appropriate  introduction  to  the  requisite  rules  for 
our  guidance  in  the  complex  relations  of  professional  life. 

Every  duty  or  obligation  implies,  both  in  equity  and  for  its 
successful  discharge,  a  corresponding  right.  As  it  is  the  duty  of 
a  physician  to  advise,  so  has  he  a  right  to  be  attentively  and  re- 
spectfully listened  to.  Being  required  to  expose  his  health  and 
life  for  the  benefit  of  the  community,  he  has  a  just  claim,  in  re- 
turn, on  all  its  members,  collectively  and  individually,  for  aid  to 
carry  out  his  measures,  and  for  all  possible  tenderness  and  regard 
to  prevent  needlessly  harassing  calls  on  his  services  and  unne- 
cessary exhaustion  of  his  benevolent  sympathies, 
s  His  zeal,  talents,  attainments  and  skill  are  qualities  which  he 
holds  in  trust  for  the  general  good,  and  which  cannot  be  prodi- 


16 

gaily  spent,  either  through  his  own  negligence  or  the  inconside- 
lateness  of  others,  without  wrong  and  detriment  both  to  himself 
and  to  them. 

The  greater  the  importance  of  the  subject  and  the  more  deeply 
interested  all  are  in  the  issue,  the  more  necessary  it  is  that  the 
physician — he  who  performs  the  chief  part,  and  in  whose  judg- 
ment and  discretion  under  Providence,  life  is  secured  and  death 
turned  aside — should  be  allowed  the  free  use  of  his  faculties, 
undisturbed  by  a  querulous  manner,  and  desponding,  angry,  or 
passionate  interjections,  under  the  plea  of  fear,  or  grief,  or  dis- 
appointment of  cherished  hopes,  by  the  sick  and  their  friends. 

All  persons  privileged  to  enter  the  sick  room,  and  the  number 
ought  to  be  very  limited,  are  under  equal  obligations  of  recipro- 
cal courtesy,  kindness  and  respect ;  and,  if  any  exception  be  ad- 
missible, it  cannot  be  at  the  expense  of  the  physician.  His  posi- 
tion, purposes  and  proper  efforts  eminently  entitle  him  to,  at 
least,  the  same  respectful  and  considerate  attentions  that  are  paid, 
as  a  matter  of  course  and  apparently  without  constraint,  to  the 
clergyman,  who  is  admitted  to  administer  spiritual  consolation, 
and  to  the  lawyer  who  comes  to  make  the  last  will  and  testament. 

Although  professional  duty  requires  of  a  physician,  that  he 
should  have  such  a  control  over  himself  as  not  to  betray  strong 
emotion  in  the  presence  of  his  patient,  nor  to  be  thrown  off  his 
guard  by  the  querulousness  or  even  r.u  Jeness  of  the  latter,  or  of 
his  friends  at  the  bedside,  yet,  and  the  fact  ought  to  be  generally 
known,  many  medical  men,  possessed  of  abundant  attainments 
and  resources,  are  soconstitutionally  timid  and  readily  abashed  as 
to  lose  much  of  their  self-possession  and  usefulness  at  the  critical 
moment,  if  opposition  be  abruptly  interposed  to  any  part  of  the 
plan  which  they  are  about  devising  for  the  benefit  of  their  patients. 

Medical  ethics  cannot  be  so  divided  as  that  one  part  shall  obtain 
the  full  and  proper  force  of  moral  obligations  on  physicians  uni- 
versally, and,  at  the  same  time,  the  other  be  construed  in  such  a 
way  as  to  free  society  from  all  restrictions  in  its  conduct  to  them ; 
leaving  it  to  the  caprice  of  the  hour  to  determine  whether  the 
truly  learned  shall  be  overlooked  in  favor  of  ignorant  pretenders 
— persons  destitute  alike  of  original  talent  and  acquired  fitness. 

The  choice  is  not  indifferent  in  an  ethical  point  of  view,  be- 
sides its  important  bearing  on  the  fate  of  the  sick  themselves, 
between  the  directness  and  sincerity  of  purpose,  the  honest  zeal, 
the  learning  and  impartial  observations,  accumulated  from  age 
to  age  for  thousands  of  years,  of  the  regularly  initiated  members 
of  the  medical  profession,  and  the  crooked  devices  and  low  arts, 
for  evidently  selfish  ends,  the  unsupported  promises  and  reckless 
trials  of  interloping  empirics,  whose  very  announcements  of  the 
means  by  which  they  profess  to  perform  their  wonders,  are,  for 
the  most  part,  misleading  and  false,  and,  so  far,  fraudulent. 

In  tlius  deducing  the  rights  of  a  physician  from  his  duties,  it 


IT 

is  not  meant  to  insist  on  such  a  correlative  obligation,  that  the 
withholding  of  the  right  exonerates  from  the  discharge  of  the 
duty.  Short  of  the  formal  abandonment  of  the  practice  of  his 
profession,  no  medical  man  can  withhold  his  services  from  the 
requisition  either  of  an  individual  or  of  the  community,  unless 
under  circumstances,  of  rare  occurrence,  in  which  his  compli- 
ance would  be  not  only  unjust,  but  deofrading  to  himself,  or  to  a 
professional  brother,  and  so  far  diminish  his  future  usefulness. 
In  the  discharge  of  their  duties  to  society,  physicians  must  be  ever 
ready  and  prompt  to  administer  professional  aid  to  all  applicants, 
without  prior  stipulation  of  personal  advantages  to  themselves. 

On  them  devolves,  in  a  peculiar  manner,  the  task  of  noting  all 
the  circumstances  affecting  the  public  health,  and  of  displaying 
skill  and  ingenuity  in  devising  the  best  means  for  its  protection. 

With  them  rests,  also,  the  solemn  duty  of  furnishing  accurate 
medical  testimony  in  all  cases  of  criminal  accusation  of  violence, 
by  which  health  is  endangered  and  life  destroyed,  and  in  those 
other  numerous  ones  involving  the  question  of  mental  sanity 
and  of  moral  and  legal  responsibility. 

On  these  subjects — Public  Hygiene  and  Medical  Jurisprudence 
— every  medical  man  must  be  supposed  to  have  prepared  himself 
by  study,  observation,  and  the  exercise  of  a  sound  judgment. 
They  cannot  be  regarded  in  the  light  of  accomplishments  merely: 
they  are  an  integral  part  c;f  the  science  and  practice  of  medicine. 

It  is  a  delicate  and  noble  task,  by  the  judicious  application  of 
Public  Hygiene,  to  prevent  disease  and  prolong  life ;  and  thus 
to  increase  the  productive  industry,  and,  without  assuming  the 
office  of  moral  and  religious  teaching,  to  add  to  the  civilization 
of  an  entire  people. 

In  the  performance  of  this  part  of  their  duty,  physicians  are 
enabled  to  exhibit  the  close  connection  between  hygiene  and 
morals ;  since  all  the  causes  contributing  to  the  former  are  nearly 
equally  auxiliary  to  the  latter.  Physicians,  as  conservators  of 
public  health,  are  bound  to  bear  emphatic  testimony  against 
quackery  in  all  its  forms,  whether  it  appears  with  its  usual  effron- 
tery, or  masks  itself  under  the  garb  of  philanthropy  and  some- 
times religion  itself.  By  an  anomaly  in  legislation  and  penal 
enactments,  the  laws,  so  stringent  for  the  repression  and  punish- 
ment of  fraud  in  general,  and  against  attempts  to  sell  poisonous 
substances  for  food,  are  silent,  and  of  course  inoperative,  in  the 
cases  of  both  fraud  and  poisoning  so  extensively  carried  on  by 
the  host  of  quacks  who  infest  the  land. 

The  newspaper  press,  powerful  in  the  correction  of  many 
abuses,  is  too  ready,  for  the  sake  of  lucre,  to  aid  and  abet  the 
enormities  of  quackery.  Honorable  exceptions  to  the  once  gene- 
ral practice  in  this  respect  are  becoming,  happily,  more  numer- 
ous, and  they  might  be  more  rapidly  increased,  if  ph^^sicians 
when  themselves  free  from  all  taint,  were  to  direct  the  attention 

3 


18 

of  the  editors  and  proprietors  of  newspapers,  and  of  periodical 
Avorks  in  general,  to  the  moral  bearings  of  the  snbject. 

To  those  who,  Uke  physicians,  can  best  see  the  extent  of  the 
evil,  it  is  still  more  mortifying  than  in  the  instances  already  men- 
tioned, to  find  members  of  other  professions,  and  especially  min- 
isters of  the  Gospel,  so  prone  to  give  their  countenance,  and,  at 
times,  direct  patronage,  to  medical  empirics,  both  by  their  use  of 
nostrums,  and  by  their  certificates  in  favor  of  the  absurd  preten- 
sions of  these  impostors.  The  credulous,  on  these  occasions, 
place  themselves  in  the  dilemma  of  bearing  testimony  either  to 
a  miracle  or  to  an  imposture:  to  a  miracle,  it  one  particular  agent, 
and  it  often  of  known  inertness  or  slight  power,  can  cure  all  di- 
seases, or  even  any  one  disease  in  all  its  stages ;  to  an  imposture,  if 
the  alleged  cures  are  not  made,  as  experience  shows  they  are  not. 

But  by  no  class  are  quack  medicines  and  nostrums  so  largely 
sold  and  distributed  as  by  apothecaries,  whose  position  towards 
physicians,  although  it  may  not  amount  to  actual  affinity,  is  such 
that  it  ought,  at  least,  to  prevent  them  from  entering  into  an 
actual,  if  not  formally  recognized,  alliance  with  empirics  of  every 
grade  and  degree  of  pretension. 

Too  frequently  we  meet  with  physicians  who  deem  it  a  venial 
error  in  ethics,  to  permit,  and  even  to  recommend,  the  use  of  a 
quack  medicine  or  secret  compound  by  their  patients  and  friends. 
They  forget  that  their  toleration  implies  sanction  of  a  recoiu'se 
by  the  people  generally  to  unknown,  doubtful  and  conjectural 
fashions  of  medication  ;  and  that  the  credulous  in  this  way  soon 
become  the  victims  of  an  endless  succession  of  empirics.  It 
must  have  been  generally  noticed,  also,  that  they,  whose  faith  is 
strongest  in  the  most  absurd  pretensions  of  quackery,  entertain 
the  greatest  skepticism  towards  regular  and  philosophic  medicine. 

Adverse  alike  to  ethical  propriety  and  to  medical  logic,  are  the 
various  popular  delusions  which,  like  so  many  epidemics,  have, 
in  successive  ages,  excited  the  imagination  with  extravagant 
expectations  of  the  cure  of  all  diseases  and  the  prolongation  of 
life  beyond  its  customary  limits,  by  means  of  a  single  substance. 
Although  it  is  not  in  the  power  of  physicians  to  prevent,  or 
always  to  arrest,  these  delusions  in  their  progess,  yet  it  is  incum- 
bent on  them,  from  their  superior  knowledge  and  better  oppor- 
tunities, as  well  as  from  their  elevated  vocation,  steadily  to  refuse 
to  extend  to  them  the  slightest  countenance,  still  less  support. 

These  delusions  are  sometimes  manifested  in  the  guise  of  a  new 
and  infallible  system  of  medical  practice, — the  faith  in  which, 
among  the  excited  believers,  is  usually  in  the  inverse  ratio  of 
the  amount  of  common  sense  evidence  in  its  favor.  Among  the 
volunteer  missionaries  for  its  dissemination,  it  is  painful  to  see 
members  of  the  sacred  profession,  who,  above  all  others,  ought 
to  keep  aloof  from  vagaries  of  any  description,  and  especially  of 
those  medical  ones  which  are  allied  to  empirical  imposture. 


19 

The  plea  of  good  intention  is  not  an  adequate  reason  for  the 
assumption  of  so  grave  a  responsibihty  as  the  propagation  of  a 
theory  and  practice  of  medicine,  of  the  real  foundation  and  nature 
of  which  the  mere  medical  amateur  must  necessarily,  from  his 
want  of  opportunities  for  study,  observation,  and  careful  com- 
parison, be  profoundly  ignorant. 

In  their  relations  with  the  sick,  physicians  are  bound  by  every 
consideration  of  duty,  to  exercise  the  greatest  kindness  with  the 
greatest  circumspection ;  so  that  whilst  they  make  every  allowance 
for  impatience,  irritation  and  inconsistencies  of  manner  and  speech 
of  the  sufferers,  and  do  their  utmost  to  sooth  and  tranquilize,  they 
shall  at  the  same  time  elicit  from  them  and  the  persons  in  their  con- 
fidence, a  revelation  of  all  the  circumstances  connected  with  the 
probable  origin  of  the  diseases  which  they  are  calledupon  to  treat. 

Owing  either  to  the  confusion  and,  at  times,  obliquity  of  mind 
produced  by  the  disease,  or  to  considerations  of  false  delicacy 
and  shame,  the  truth  is  not  always  directly  reached  on  these  oc- 
casions; and  hence  the  necessity,  on  the  part  of  the. physician, 
of  a  careful  and  minute  investigation  into  both  the  physical  and 
moral  state  of  his  patient.  A  physician  in  attendance  on  a  case 
should  avoid  expensive  complications  and  tedious  ceremonials, 
as  being  beneath  the  dignity  of  true  science  and  embarrassing  to 
the  patient  and  his  family,  whose  troubles  are  already  great. 

In  their  intercourse  with  each  other,  physicians  will  best  con- 
sult and  secure  their  own  self-respect  and  consideration  from  so- 
ciety in  general,  by  a  uniform  courtesy  and  high-minded  conduct 
towards  their  professional  brethren.  The  confidence  in  his  intellec- 
tual and  moral  worth,  which  each  member  of  the  profession  is  am- 
bitious of  obtaining  for  himself  among  his  associates,  ought  to  make 
him  willing  to  place  the  same  confidence  in  the  worth  of  others. 

Veracity,  so  requisite  in  all  the  relations  of  life,  is  a  jewel  of 
inestimable  value  in  medical  description  and  narrative,  the  lustre 
of  which  ought  never  to  be  tarnished  for  a  moment,  by  even  the 
breath  of  suspicion.  Pliysicians  are  peculiarly  enjoined,  by  every 
consideration  of  honour  and  of  conscientious  regard  for  the  health 
and  lives  of  their  fellow  beings,  not  to  advance  any  statement 
unsupported  by  positive  facts,  nor  to  hazard  an  opinion  or  hypo- 
thesis that  is  not  the  result  of  deliberate  inquiry  into  all  the  data 
and  bearings  of  which  the  subject  is  capable.  Hasty  generali- 
zation, paradox,  and  fanciful  conjectures,  repudiated  at  all  times 
by  sound  logic,  are  open  to  the  severest  reprehension  on  the  still 
higher  grounds  of  humanity  and  morals.  Their  tendency  and 
practical  operation  cannot  fail  to  be  eminently  mischievous. 

Among  medical  men  associated  together  for  the  performance 
of  professional  duties  in  public  institutions,  such  as  Medical  Col- 
leges, Hospitals  and  Dispensaries,  there  ought  to  exist,  not  only 
harmonious  intercourse,  but  also  a  general  harmony  in  doctrine 
and  practice:  so  that  neither  student  nor  patients  shall  be  per- 


20 

plexed,  nor  the  medical  commniiity  mortified  by  contradictory 
views  of  the  theory  of  disease,  if  not  of  the  means  of  curing  it. 

The  right  of  free  inquiry,  common  to  all,  does  not  imply  the 
utterance  of  crude  hypothesis,  the  use  of  figurative  language,  a 
straining  after  novelty  for  novelty's  sake,  and  the  involution  of 
old  truths,  for  temporary  effect  and  popularity,  by  medical  wri- 
ters and  teachers.  If,  therefore,  they  who  are  engaged  in  a  com- 
mon cause,  and  for  the  furtherance  of  a  common  object,  could 
make  an  offering  of  the  extreme,  the  doubtful,  and  the  redundant, 
at  the  shrine  of  philosophical  truth,  the  general  harmony  in 
medical  teaching,  now  desired,  would  be  of  easy  attainment. 

It  is  not  enough,  however,  that  the  members  of  the  medical 
profession  be  zealous,  well  informed  and  self-denying,  unless  the 
social  principle  be  cultivated  by  their  seeking  frequent  intercourse 
with  each  other,  and  cultivating,  reciprocally,  friendly  habits  of 
acting  in  common.  By  union  alone  can  medical  men  hope  to 
sustain  the  dignity  and  extend  the  usefulness  of  their  profession. 
Among  the  chief  means  to  bring  about  this  desirable  end,  are 
frequent  social  meetings  and  regularly  organized  Societies ;  a  part 
of  whose  beneficial  operation  would  be  an  agreement  on  a  suita- 
ble standard  of  medical  education,  and  a  code  of  medical  ethics. 

Greatly  increased  influence,  for  the  entire  body  of  the  profes- 
sion, will  be  acquired  by  a  union  for  the  purposes  of  common 
benefit  and  the  general  good ;  while  to  its  members,  individually, 
will  be  insured  a  more  pleasant  and  harmonious  intercourse,  one 
with  another,  and  an  avoidance  of  many  heartburnings  and 
jealousies,  which  originate  in  misconceptions,  through  misrepre- 
sentation on  the  part  of  individuals  in  general  society,  of  each 
other's  disposition,  motives  and  conduct.  In  vain  will  physicians 
appeal  to  the  intelligence  and  elevated  feelings  of  the  members 
of  other  professions,  and  of  the  better  part  of  society  in  general, 
unless  they  be  true  to  themselves,  by  a  close  adherence  to  their 
duties,  and  by  firmly  yet  mildly  insisting  on  their  rights;  and 
this  not  with  a  glimmering  perception  and  faint  avowal,  but 
rather  with  a  full  understanding  and  firm  conviction. 

Impressed  with  the  nobleness  of  their  vocation,  as  trustees  of 
science  and  almoners  of  benevolence  and  charity,  physicians 
should  use  unceasing  vigilance  to  prevent  the  introduction  into 
their  body  of  those  who  have  not  been  prepared  by  a  suitably 
preparatory  moral  and  intellectual  training. 

No  youth  ought  to  be  allowed  to  study  medicine,  whose  capa- 
city, good  conduct,  and  elementary  knowledge  are  not  equal,  at 
least,  to  the  common  standard  of  academical  requirements. 

Human  life  and  human  happiness  must  not  be  endangered  by 
the  incompetency  of  presumptuous  pretenders.  The  greater  the 
inherent  difficulties  of  medicine,  as  a  science,  and  the  more  nu- 
merous the  complications  that  embarrass  in  its  practice,  the  more 
necessary  is  it  that  there  should  be  minds  of  a  high  order  and 


21 

tiiorougli  cultivation,  to  unravel  its  mysteries  and  to  deduce  sci- 
entific order  from  apparently  empirical  confusion. 

We  are  under  the  strongest  ethical  obligations  to  preserve  the 
character  which  has  been  awarded,  by  the  most  learned  men  and 
best  judges  of  human  nature,  to  the  members  of  the  medical 
profession,  for  general  and  extensive  knowledge,  great  liberality, 
and  dignity  of  sentiment,  and  prompt  effusions  of  beneficence. 

In  order  that  we  may  continue  to  merit  these  praises,  every 
physician,  within  the  circle  of  his  acquaintance,  should  impress 
both  fathers  and  sons  with  the  range  and  variety  of  medical  stu- 
dy, and  with  the  necessity  of  those  who  desire  to  engage  in  it, 
possessing,  not  only  good  preliminary  knowledge,  but,  likewise, 
some  habits  of  regular  and  systematic  thinking. 

If  able  teachers  and  writers,  and  profound  inquirers,  be  still 
called  for  to  expound  medical  science,  and  to  extend  its  domain 
of  practical  application  and  usefulness,  they  cannot  be  procured 
by  intuitive  effort  on  their  own  part,  nor  by  the  exercise  of  the 
elective  suffrage  on  the  part  of  others.  They  must  be  the  pro- 
duct of  a  regular  and  comprehensive  system, — members  of  a 
large  class,  from  the  great  body  of  which  they  only  differ  by  the 
force  of  fortuitous  circumstances,  that  gives  them  temporary 
vantage  ground  for  the  display  of  qualities  and  attainments  com- 
mon to  their  brethren. 


CHAPTER   I. 

OF  THE    DUTIES  OF  PHYSICIANS  TO   THEIR  PATIENTS  AND  OF 
THE  OBLIGATIONS  OF  PATIENTS  TO  THEIR  PHYSICIANS. 

Art.  I. — Duties  of  Physicians  to  their  Patients. 

§  1.  A  Physician  should  not  only  be  ever  ready  to  obey  the 
calls  of  the  sick,  but  his  mind  ought  also  to  be  imbued  with  the 
greatness  of  his  mission,  and  the  responsibility  he  habitually 
incurs  in  its  discharge.  Those  obligations  are  the  more  deep 
and  enduring,  because  there  is  no  tribunal  other  than  his  own 
conscience,  to  adjudge  penalties  for  carelessness  or  neglect. 
Physicians  should,  therefore,  minister  to  the  sick  with  due  impres- 
sions of  the  importance  of  their  office ;  reflecting  that  the  ease,  the 
health  and  the  lives  of  those  committed  to  their  charge  depend 
on  their  skill,  attention,  and  fidelity.  They  should  study,  also, 
in  their  deportment,  so  to  unite  tenderness  with  firmness,  and 
condescension  with  authority^  as  to  inspire  the  minds  of  their 
patients  with  gratitude,  respect  and  confidence. 

§  2.  Every  case  committed  to  the  charge  of  a  physician  should 
be  treated  with  attention,  steadiness  and  humanity.  Reasonable 
indulgence  should  be  granted  to  the  mental  imbecility  and  ca- 
prices of  the  sick.  Secrecy  and  delicacy,  when  required  by  pe- 
culiar circumstances,  should  be  strictly  observed:  and  the  familiar 
and  confidential  intercourse  to  which  physicians  are  admitted  in 


22 

their  professional  visits,  should  be  used  with  discretion,  and  with 
tlie  most  scmpnlous  regard  to  fidelity  and  honor.  The  obliga- 
tion of  secrecy  extends  beyond  the  period  of  professional  services; 
none  of  the  privacies  of  personal  and  domestic  life,  no  infirmity 
of  disposition  or  flaw  of  character  observed  during  professional 
attendance,  should  ever  be  divulged  by  him  except  when  he  is 
imperatively  required  to  do  so.  The  force  and  necessity  of  this 
obligation  are  indeed  so  great,  that  professional  men  have,  under 
certain  circumstances,  been  protected  in  their  observance  of  se- 
crecy by  courts  of  justice. 

§  3.  Frequent  visits  to  the  sick  are  in  general  requisite,  since 
they  enable  the  physician  to  arrive  at  a  more  perfect  knowledge 
of  the  disease, — to  meet  promptly  every  change  which  may  oc- 
cur, and  also  tend  to  preserve  the  confidence  of  the  patient.  But 
unnecessary  visits  are  to  be  avoided,  as  they  give  useless  anxiety 
to  the  patient,  tend  to  diminish  the  authority  oi  the  physician, 
and  render  him  liable  to  be  suspected  of  interested  motives. 

§  4.  A  physician  should  not  be  forward  to  make  gloomy 
prognostications,  because  they  savour  of  empiricism,  by  magni- 
fying the  importance  of  his  services  in  the  treatment  or  cure  of 
the  disease.  But  he  should  not  fail,  on  proper  occasions,  to  give 
to  the  friends  of  the  patient  timely  notice  of  danger,  when  it 
really  occurs ;  and  even  to  the  patient  himself,  if  absolutely  ne- 
cessary. This  oflice,  however,  is  so  peculiarly  alarming  when 
executed  by  him,  that  it  ought  to  be  declined  whenever  it  can 
be  assigned  to  any  other  person  of  sufficient  judgment  and  deli- 
cacy. For,  the  physician  should  be  the  minister  of  hope  and 
comfort  to  the  sick  ;  that,  by  such  cordials  to  the  drooping  spirit, 
he  may  smooth  the  bed  of  death,  revive  expiring  life,  and  coun- 
teract the  depressing  influence  of  those  maladies  whicli  often 
disturb  the  tranquillity  of  the  most  resigned,  in  their  last  mo- 
ments. The  life  of  a  sick  person  can  be  shortened  not  only  by 
the  acts,  but  also  by  the  words  or  manner  of  a  physician.  It  is, 
therefore,  a  sacred  duty  to  guard  himself  carefully  in  this  res- 
pect, and  to  avoid  all  things  which  have  a  tendency  to  discour- 
age the  patient  and  to  depress  his  spirits. 

§  5.  A  physician  ought  not  to  abandon  a  patient  because  the 
case  is  deemed  incurable;  for  his  attendance  may  continue  to 
be  highly  useful  to  the  patient,  and  comforting  to  the  relatives 
around  him,  even  in  the  last  period  of  a  fatal  malady,  by  alleviat- 
ing pain  and  other  symptoms,  and  by  soothing  mental  anguish. 
To  decline  attendance,  under  such  circumstances,  would  be  sac- 
rificing to  fanciful  delicacy  and  mistaken  liberality,  that  moral 
duty  which  is  independent  of,  and  far  superior  to,  all  pecuniary 
considerations. 

§  0.  Consultations  should  be  ])romoted  in  diflicult  or  pro- 
tracted cases,  as  they  give  rise  to  confidence,  energy,  and  niore 
enlarged  views  in  practice. 


23 

§  7.  The  opportiuiity  which  a  physician  not  unfrequently 
enjoys  of  promoting  and  strengthening  the  good  resohitions  of 
his  patients,  suffering  nnder  the  consequences  of  vicious  conduct, 
ought  never  to  be  neglected.  His  counsels,  or  even  remonstran- 
ces, will  give  satisfaction,  not  offence,  if  they  be  proffered  with 
politeness,  and  evince  a  genuine  love  of  virtue,  accompanied  by 
a  sincere  interest  in  the  welfare  of  the  person  to  whom  they  are 
addressed. 

Art.  it. —  Obligations  of  Patienfs  to  their  Physicians. 

h  1.  The  members  of  the  medical  profession,  upon  whom  are 
enjoined  the  performance  of  so  many  important  and  arduous  du-^ 
ties  towards  the  community,  and  who  are  required  to  make  so 
many  sacrifices  of  comfort,  ease,  and  health,  for  the  welfare  of 
those  who  avail  themselves  of  their  services,  certainly  haveario^ht 
to  expect  and  require,  that  their  patients  should  entertain  a  just 
sense  of  the  duties  which  they  owe  to  their  medical  attendants. 

§  2.  The  first  duty  of  a  patient  is,  to  select  as  his  medical  ad- 
viser one  who  has  received  a  regular  professional  education.  In 
no  trade  or  occupation,  do  mankind  rely  on  the  skill  of  an  un- 
taught artist ;  and  in  medicine,  confessedly  the  most  diflicult  and 
intricate  of  the  sciences,  the  world  ought  not  to  suppose  that 
knowledge  is  intuitive. 

§  3.  Patients  should  prefer  a  physician  whose  habits  of  life 
are  regular,  and  who  is  not  devoted  to  company,  pleasure,  or  to 
any  pursuit  incompatible  with  his  professional  obligations.  A 
patient  should,  also,  confide  the  care  of  himself  and  family,  as 
much  as  possible,  to  one  physician,  for  a  medical  man  who  has  be- 
come acquainted  with  the  peculiarities  of  constitution,  habits,  and 
predispositions  of  those  he  attends,  is  more  likely  to  be  successful 
in  his  treatment,  than  one  who  does  not  possess  that  knowledge. 

A  patient  who  has  thus  selected  his  physician,  should  always 
apply  for  advice  in  what  may  appear  to  him  trivial  cases,  for  the 
most  fatal  results  often  supervene  on  the  slightest  accidents.  It 
is  of  still  more  importance  that  he  should  apply  for  assistance  in 
the  forming  stage  of  violent  diseases  ;  it  is  to  a  neglect  of  this 
precept  that  medicine  owes  much  of  the  uncertainty  and  imper- 
fection with  which  it  has  been  reproached. 

§  4.  Patients  should  faithfully  and  unreservedly  communicate 
to  their  physician  the  supposed  cause  of  their  disease.  This  is 
the  more  important,  as  many  diseases  of  a  mental  origin  simulate 
those  depending  on  external  causes,  and  yet  are  only  to  be  cured 
by  ministering  to  the  mind  diseased.  A  patient  should  never  be 
afraid  of  thus  making  his  physician  his  friend  and  adviser;  he 
should  always  bear  in  mind  that  a  medical  man  is  under  the 
strongest  obligations  of  secrecy.  Even  the  female  sex  should 
never  allow  feelings  of  shame  or  delicacy  to  prevent  their  disclos- 
ing the  seat,  symptoms  and  causes  of  complaints  peculiar  to  them. 
However  commendable  a  modest  reserve  maybe  in  the  common 


24 

occnnences  of  life,  its  strict  observance  in  medicine  is  often  at- 
tended Avith  the  most  serious  consequences,  and  a  patient  may 
sink  under  a  painful  and  loathsome  disease,  which  might  have 
been  readily  prevented,  had  timely  intimation  been  given  to  the 
physician. 

§  5.  A  patient  should  never  weary  his  physician  with  a  tedi- 
ous detail  of  events  or  matters  not  appertaining  to  his  disease. 
Even  as  relates  to  his  actual  symptoms,  he  will  convey  much 
more  real  information  by  giving  clear  answers  to  interrogatories, 
than  by  the  most  minute  account  of  his  own  framing.  Neither 
should  he  obtrude  the  details  of  his  business  nor  the  history  of 
his  family  concerns. 

§  6.  The  obedience  of  a  patient  to  the  prescriptions  of  his 
physician  should  be  prompt  and  implicit.  He  should  never  per- 
mit his  own  crude  opinions  as  to  their  fitness,  to  influence  his 
attention  to  them.  A  failure  in  one  particular  may  render  an 
otherwise  judicious  treatment  dangerous,  and  even  fatal.  This 
remark  is  equally  applicable  to  diet,  drink,  and  exercise.  As 
patients  become  convalescent  they  are  very  apt  to  suppose  that 
the  rules  prescribed  for  them  may  be  disregarded,  and  the  con- 
sequence but  too  often,  is  a  relapse.  Patients  should  never  allow 
themselves  to  be  persuaded  to  take  any  medicine  whatever,  that 
may  be  recommended  to  them  by  the  self-constituted  doctors 
and  doctresses,  who  are  so  frequently  met  with,  and  who  pretend 
to  possess  infallible  remedies  for  the  cure  of  every  disease.  How- 
ever simple  some  of  their  prescriptions  may  appear  to  be,  it  often 
happens  that  they  are  productive  of  much  mischief,  and  in  all 
cases  they  are  injurious,  by  contravening  the  plan  of  treatment 
adopted  by  the  physician. 

§  7.  A  patient  should,  if  possible,  avoid  even  ihe  friendly 
visits  of  a  physician  who  is  not  attending  hini; — and  when  he 
does  receive  them,  he  should  never  converse  on  the  subject  of 
his  disease,  as  an  observation  may  be  made,  without  any  inten- 
tion of  interference,  which  may  destroy  his  confidence  in  the 
course  he  is  pursuing,  and  induce  him  to  neglect  the  directions 
prescribed  to  him.  A  patient  should  never  send  for  a  consulting 
physician  without  the  express  consent  of  his  own  medical  attend- 
ant. It  is  of  great  importance  that  physicians  should  act  in  con- 
cert; for,  although  their  modes  of  treatment  may  be  attended 
with  equal  success  when  employed  singly,  yet  conjointly  they 
are  very  likely  to  be  productive  of  disastrous  results. 

§  8.  When  a  patient  wishes  to  dismiss  his  physician,  justice 
and  common  courtesy  require  that  he  should  declare  his  reasons 
for  so  doing. 

§  9.  Patients  should  always,  when  practicable,  send  for  their 
physician  in  the  morning,  before  his  usual  hour  of  going  out; 
for,  by  being  early  aware  of  the  visits  he  has  to  pay  during  the 
day,  the  physician  is  able  to  apportion  his  time  in  sucli  a  manner 


25 

as  to  prev^ent  an  interference  of  engagements.  Patients  should 
also  avoid  calling  on  their  medical  adviser  nnnecessarily  during 
the  hours  devoted  to  meals  or  sleep.  They  should  always  be  in 
readiness  to  receive  the  visits  of  their  physician,  as  the  detention 
of  a  few- minutes  is  often  of  serious  inconvenience  to  him. 

§  10.  A  patient  should,  after  his  recovery,  entertain  a  just  and 
enduring  sense  of  the  value  of  the  services  rendered  him  by  his 
physician;  for  tliese  are  of  such  a  character,  that  no  mere  pecu- 
niary acknowledgment  can  repay  or  cancel  them. 


CHAPTER  II. 

OF  THE   DUTIES  OF   PHYSICIANS  TO  EACH  OTHER,  AND  TO  THE 

PROFESSION  AT  LARGE. 

Art.  I. — Dnlies  for  the  s7fppo7^(  of  })rofessional  character. 

§  1.  Every  individual,  on  entering  the  profession,  as  he  be- 
comes thereby  entitled  to  all  its  privileges  and  immunities,  incurs 
an  obligation  to  exert  his  best  abilities  to  maintain  its  dignity 
and  honor,  to  exalt  its  standing,  and  to  extend  the  bounds  of  its 
usefulness.  He  should  therefore  observe  strictly,  such  laws  as 
are  instituted  for  the  government  of  its  members — should  avoid 
all  contumelious  and  sarcastic  remarks  relative  to  the  faculty,  as 
a  body ;  and  while,  by  unwearied  diligence,  he  resorts  to  every 
honorable  means  of  enriching  the  science,  he  should  entertain  a 
due  respect  for  his  seniors,  who  have,  by  their  labours,  brought 
it  to  the  elevated  position  in  which  he  finds  it. 

§  2.  There  is  no  profession,  from  the  member  of  which  greater 
purity  of  character,  and  a  higher  standard  of  moral  excellence 
are  required,  than  the  medical ;  and  to  attain  such  eminence,  is 
a  duty  every  physician  owes  alike  to  his  profession,  and  to  his 
patients.  It  is  due  to  the  latter,  as  without  it  he  cannot  command 
their  respect  and  confidence,  and  to  both,  because  no  scientific 
attainments  can  compensate  for  the  Avant  of  correct  moral  princi- 
ples. It  is  also  incumbent  upon  the  faculty  to  be  temperate  in 
all  things,  for  the  practice  of  physic  requires  the  unremitting 
exercise  of  a  clear  and  vigorous  understanding  ;  and,  on  emer- 
gencies for  which  no  professional  man  should  be  unprepared,  a 
steady  hand,  an  acute  eye,  and  an  unclouded  head  may  be  essen- 
tial to  the  well-being,  and  even  to  the  life  of  a  fellow  creature. 

§  3.  It  is  derogatory  to  the  dignity  of  the  profession,  to  resort 
to  public  advertisements  or  private  cards  or  handbills,  inviting 
the  attention  of  individuals  affected  with  particular  diseases — 
publicly  offering  advice  and  medicine  to  the  poor  gratis,  or  pro- 
mising radical  cures;  or  to  publish  cases  and  operations  in  the 
daily  prints  or  suffer  such  publications  to  be  made; — to  invite 
laymen  to  be  present  at  operations, — to  boast  of  cures  and  reme- 
dies,— to  adduce  certificates  of  skill  and  success,  or  to  perform 

4 


2G 

any  other  similar  acts.     These  are  the  ordinary  practices  of  em- 
pirics, and  are  highly  reprehensible  in  a  regular  physician. 

§  4.  Equally  derogatory  to  professional  character  is  it,  for  a 
physician  to  hold  a  patent  for  any  surgical  instrument,  or  medi- 
cine ;  or  to  dispense  a  secret  nostrum^  whether  it  be  the  compo- 
sition or  exclusive  property  of  himself,  or  of  others.  For,  if  such 
nostrum  be  of  real  efficacy,  any  concealment  regarding  it  is  in- 
consistent with  beneficence  and  professional  liberality;  and,  if 
mystery  alone  give  it  value  and  importance,  such  craft  implies 
either  disgraceful  ignorance,  or  fraudulent  avarice.  It  is  also  re- 
prehensible for  physicians  to  give  certificates  attesting  the  efficacy 
of  patent  or  secret  medicines,  or  in  any  way  to  promote  the  use 
of  them. 

Art.  II. — Prof  essional  services  of  physicians  to  each  other. 

§  1.  All  practitioners  of  medicine,  their  wives,  and  their  chil- 
dren, while  under  the  paternal  care,  are  entitled  to  the  gratuitous 
services  of  any  one  or  more  of  the  faculty  residing  near  them, 
whose  assistance  may  be  desired.  A  physician  afflicted  with 
disease  is  usually  an  incompetent  judge  of  his  own  case;  and  the 
natural  anxiety  and  solicitude  which  he  experiences  at  the  sick- 
ness of  a  wife,  a  child,  or  any  one  who  by  the  ties  of  consan- 
guinity is  rendered  peculiarly  dear  to  him,  tend  to  obscure  his 
judgment,  and  produce  timidity  and  irresolution  in  his  practice. 
Under  such  circumstances,  medical  men  are  peculiarly  depend- 
ent upon  each  other,  and  kind  offices  and  professional  aid  should 
always  be  cheerfully  and  gratuitously  afforded.  Visits  ought 
not,  however,  to  be  obtruded  officiously;  as  such  unasked  civility 
may  give  rise  to  embarrassment,  or  interfere  Avith  that  choice,  on 
which  confidence  depends.  But,  if  a  distant  member  of  the 
faculty,  whose  circumstances  are  affluent,  request  attendance, 
and  an  honorarium  be  oifered,  it  should  not  be  declined ;  for  no 
pecuniary  obligation  ought  to  be  imposed,  which  the  party  re- 
ceiving it  would  wish  not  to  incur. 

Art.  III. — Of  the  duties  of  the  jyhysician  as  respects  vica- 
rious offices. 

§  1.  The  aflfairs  of  life,  the  pmsuit  of  health,  and  the  various 
accidents  and  contingencies  to  which  a  medical  man  is  peculiar- 
ly exposed,  sometimes  require  him  temporarily  to  withdraw  from 
his  duties  to  his  patients,  and  to  request  some  of  his  professional 
brethren  to  officiate  for  him.  Compliance  with  this  request  is  an 
act  of  courtesy,  which  should  always  be  performed  with  the  ut- 
most consideration  for  the  interest  and  character  of  the  family 
physician,  and  when  exercised  for  a  short  period,  all  tlie  pecuni- 
ary obligations  for  such  service  should  be  awarded  to  him.  But  if 
a  member  of  the  profession  neglect  his  business  in  quest  of  plea- 
sure and  amusement,  he  cannot  be  considered  as  entitled  to  the 
advantages  of  the  frequent  and  long-continued  exercise  of  this 


27 

iValernal  courtesy,  without  awadiug  to  the  pliysiciau  who  oflici- 
ates*  the  fees  arising  from  the  discharge  of  liis  professional  duties. 

Art.  IV. —  Of  the  duties  of  physicians  in  regard  to  Con- 
suit  at  ions.  * 

§  1.  A  regular  medical  education  furnishes  the  only  presump- 
tive evidence  of  professional  abilities  and  acquirements,  and  ought 
to  be  the  only  acknowledged  right  of  an  individual  to  the  exer- 
cise and  honors  of  his  profession.  Nevertheless,  as  in  consulta- 
tions the  good  of  the  patient  is  the  sole  object  in  view,  and  this  is 
often  dependent  on  personal  confidence,  no  intelligent  regular 
practitioner,  who  has  a  license  to  practice  from  some  medical  board 
of  known  and  acknowledged  respectability,  recognized  by  this  as- 
sociation, and  who  is  in  good  moral  and  professional  standing  in 
the  place  in  which  he  resides,  should  be  fastidiously  excluded 
from  fellowship,  or  his  aid  refused  in  consultation,  when  it  is  re- 
quested by  the  patient.  But  no  one  can  be  considered  as  a  regu- 
lar practitioner,  or  a  fit  associate  in  consultation,  whose  practice 
it  based  on  an  exclusive  dogma,  to  the  rejection  of  the  accumu- 
lated experience  of  the  profession,  and  of  the  aids  actually  fur- 
nished by  anatomy,  physiology,  pathology  and  organic  chemistry. 

§  2.  In  consultations  no  rivalship  or  jealousy  should  be  in- 
dulged ;  candour,  probity,  and  all  due  respect  should  be  exercised 
towards  the  physician  having  charge  of  the  case. 

§  3.  In  consultations  the  attending  physician  should  be  the 
first  to  propose  the  necessary  questions  to  the  sick;  after  which 
the  consulting  physician  should  have  tlie  opportunity  to  make 
such  further  inquiries  of  the  patient  as  may  be  necessary  to  satisfy 
him  of  the  true  character  of  the  case.  Both  physicians  should 
then  retire  to  a  private  place  for  deliberation ;  and  the  one  first  in 
attendance  should  communicate  the  directions  agreed  upon  to  the 
patient  or  his  friends,  as  well  as  any  opinions  which  it  may  be 
thought  proper  to  express.  But  no  statement  or  discussion  of  it 
should  take  place  before  the  patient  orJiis  friends,  except  in  the 
presence  of  all  the  faculty  attending,  and  by  their  common  consent; 
and  no  opinions  or  prognosticatiotis  should  be  delivered,  Avhich 
are  not  the  result  of  previous  deliberation  and  concurrence. 

§  4.  In  consultations,  the  physician  in  attendance  should  de- 
liver his  opinion  first ;  and  when  there  are  several  consulting, 
they  should  deliver  their  opinions  in  the  order  in  which  they 
have  been  called  in.  No  decision,  however,  should  restrain  the 
attending  physician  from  making  such  variations  in  the  mode  of 
treatment,  as  any  subsequent  unexpected  change  in  the  charac- 
ter of  the  case  may  demnnd.  But  such  variation  and  the  reasons 
for  it  ought  to  be  carefully  detailed  at  the  next  meeting  in  con- 
sultation. The  same  privilege  belongs  also  to  the  consulting 
physician  if  he  is  sent  for  in  an  emergency,  when  the  regular 
attendant  is  out  of  the  way,  and  similar  explanations  must  be 
made  by  him,  at  the  next  consultation. 


28 

§  5.  The  utmost  punctuality  should  be  observed  in  the  visits 
of  physicians  when  they  are  to  hold  consultation  together,  and 
this  is  generally  practicable,  for  society  has  been  considerate 
enough  to  allow  the  plea  of  a  professional  engagement  to  take 
precedence  of  all  others,  and  to  be  an  ample  reason  for  the  relin- 
quishment of  any  present  occupation.  But  as  professional  en- 
gagements may  sometimes  interfere,  and  delay  one  of  the  parties, 
the  physician  who  first  arrives  should  wait  for  his  associate  a 
reasonable  period,  after  which  the  consultation  should  be  con- 
sidered as  postponed  to  a  new  appointment.  If  it  be  the  attend- 
ing physician  who  is  present,  he  will  of  course  see  the  patient 
and  prescribe;  but  if  it  be  the  consulting  one,  he  should  retire, 
except  in  case  of  emergency,  or  when  he  has  been  called  from  a 
considerable  distance,  in  which  latter  case  he  may  examine  the 
patient,  and  give  his  opinion  in  loriting  and  under  seal,  to  be 
delivered  to  his  associate. 

§  6.  In  consultations,  theoretical  discussions  should  be  avoid- 
ed, as  occasioning  perplexity  and  loss  of  time.  For  there  may 
be  much  diversity  of  opinion  concerning  speculative  points, 
with  perfect  agreement  in  those  modes  of  practice  which  are 
founded,  not  on  hypothesis,  but  on  experience  and  observation. 

§  7.  All  discussions  in  consultation  should  be  held  as  secret 
and  confidential.  Neither  by  Avords  nor  manner  should  any  of 
the  parties  to  a  consultation  assert  or  insinuate,  that  any  part  of 
the  treatment  pursued  did  not  receive  his  assent.  The  responsi- 
bility must  be  equally  divided  between  the  medical  attendants ; 
they  must  equally  share  the  credit  of  success  as  well  as  the 
blame  of  failure. 

§  8.  Should  an  irreconcilable  diversity  of  opinion  occur  when 
several  physicians  are  called  upon  to  consult  together,  the  opin- 
ion of  the  majority  should  be  considered  as  decisive;  but  if  the 
numbers  be  equal  on  each  side,  then  the  decision  should  rest 
with  the  attending  physician.  It  may,  moreover,  sometimes 
happen,  that  two  physicians  cannot  agree  in  their  views  of  the 
nature  of  a  case,  and  the  treatment  to  be  pursued.  This  is  a 
circumstance  much  to  be  deplored,  and  should  always  be  avoid- 
ed, if  possible,  by  mutual  concessions,  as  far  as  they  can  be  jus- 
tified by  a  conscientious  regard  for  the  dictates  of  judgment. 
But  in  the  event  of  its  occurrence,  a  third  physician  should,  if 
practicable,  be  called  to  act  as  umpire,  and  if  circumstances  pre- 
vent the  adoption  of  this  course,  it  must  be  left  to  the  patient  to 
select  the  physician  in  whom  he  is  most  willing  to  confide.  But 
as  every  physician  relies  upon  the  rectitude  of  his  judgment,  he 
should,  when  left  in  the  minority,  politely  and  consistently 
retire  from  any  further  deliberation  in  the  consultation,  or  par- 
ticipation in  the  management  of  the  case. 

§  9.  As  circumstances  sometimes  occur  to  render  a  special 
consultation  desirablcj  when  the  continued  attendance  of  two 


29 

pliystciaiis  might  be  objectionable  to  tlie  patient,  the  member  of 
the  laciilty  whose  assistance  is  required  in  such  Ccises,  should 
sedulously  guard  against  all  future  unsolicited  attendance.  As 
such  consultations  require  an  extraordinary  portion  both  of  time 
and  attention,  at  least  a  double  honorarium  may  be  reasonably 
expected, 

§  10.  A  physician  who  is  called  upon  to  consult,  should  ob- 
serve the  most  honorable  and  scrupulous  regard  for  the  character 
and  standing  of  the  practitioner  in  attendance:  the  practice  of  the 
latter,  if  necessary,  should  be  justified  as  far  as  it  can  be,  consist- 
ently with  a  conscientious  regard  for  truth,  and  no  hint  or  in- 
sinuation should  be  thrown  out,  which  could  impair  the  confi- 
dence reposed  in  him,  or  affect  his  reputation.  The  consulting 
physician  should  also  carefnlly  refrain  from  any  of  those  extra- 
ordinary attentions  or  assiduities,  which  are  too  often  practiced 
by  the  dishonest  for  the  base  purpose  of  gaining  applause,  or  in- 
gratiating themselves  into  the  favor  of  families  and  individuals. 

Art.  V. — Duties  of  physicians  in  cases  of  inteiference. 

§  1.  Medicine  is  a  liberal  profession,  and  those  admitted  into 
its  ranks  should  found  their  expectations  of  practice  upon  the 
extent  of  their  qualifications,  not  on  intrigue  or  artifice. 

§  2.  A  physician,  in  his  intercourse  with  a  patient  under  the 
care  of  another  practitioner,  should  observe  the  strictest  caution 
and  reserve.  No  meddling  inquiries  should  be  made  :  no  disin- 
genuous hints  given  relativ^e  to  the  nature  and  treatment  of  his 
disorder ;  nor  any  course  of  conduct  pursued  that  may  directly 
or  indirectly  tend  to  diminish  the  trust  reposed  in  the  physician 
employed. 

§  3.  The  same  circumspection  and  reserve  should  be  ob- 
served, when,  from  motives  of  business  or  friendship,  a  physi- 
cian is  prompted  to  visit  an  individual  who  is  under  the  direc- 
tion of  another  practitioner.  Indeed,  such  visits  should  be 
avoided,  except  under  peculiar  circumstances,  and  when  they 
are  made,  do  particular  inquiries  should  be  instituted  relative  to 
the  nature  of  the  disease,  or  the  remedies  employed,  but  the 
topics  of  conversation  should  be  as  foreign  to  the  case  as  cir- 
cumstances will  admit. 

§  4.  A  physician  ought  not  to  take  charge  of,  or  prescribe 
for  a  patient  who  has  recently  been  under  the  care  of  another 
member  of  the  faculty  in  the  same  illness,  except  in  cases  of 
sudden  emergency,  or  in  consultation  with  the  physician  previ- 
ously in  attendance,  or  when  the  latter  has  relinquished  the  case 
or  been  regularly  notified  that  his  services  are  no  longer  desired. 
Under  such  circumstances  no  unjust  and  illiberal  insinuations 
should  be  thrown  out  in  relation  to  the  conduct  or  practice  pre- 
viously pursued,  which  should  be  justified  a.s  far  as  candor,  and 
regard  for  truth  and  probity  will  permit ;  for  it  often  happens. 


30 

that  patients  become  dissatisfied  when  they  do  not  experience 
immediate  relief,  and,  as  many  diseases  are  naturally  protracted, 
the  want  of  success,  in  the  first  stage  of  treatment,  alfords  no 
evidence  of  a  lack  of  professional  knowledge  and  skill. 

§  5.  Wiien  a  physician  is  called  to  an  urgent  case,  because 
the  family  attendant  is  not  at  hand,  he  ought,  unless  his  assist- 
ance in  consultation  be  desired,  to  resign  the  care  of  the  patient 
to  the  latter  immediately  on  his  arrival. 

§  6.  It  often  happens,  in  cases  of  sudden  illness,  or  of  recent 
accidents  and  injuries,  owing  to  the  alarm  and  anxiety  of  friends, 
that  a  number  of  physicians  are  simultaneously  sent  for.  Under 
these  circumstances  courtesy  should  assis^n  the  patient  to  the 
first  who  arrives,  who  should  select  from  those  present,  any  ad- 
ditional assistance  that  he  may  deem  necessary.  In  all  sucli 
cases,  however,  the  practitioner  who  ofiiciates,  should  request 
the  family  physician,  if  there  be  one,  to  be  called,  and,  unless 
his  further  attendance  be  requested,  should  resign  the  case  to 
the  latter  on  his  arrival. 

§  7.  When  a  physician  is  called  to  the  patient  of  another 
practitioner,  in  consequence  of  the  sickness  or  absence  of  the 
latter,  he  ought,  on  the  return  or  recovery  of  the  regular  attend- 
ant, and  with  the  consent  of  the  patient,  to  surrender  the  case. 

§  8.  A  physician,  when  visiting  a  sick  person  in  the  country, 
may  be  desired  to  see  a  neighboring  patient  who  is  under  the 
regular  direction  of  another  physician,  in  consequence  of  some 
sudden  change  or  aggravation  of  symptoms.  The  conduct  to 
be  pursued  on  such  an  occasion  is  to  give  advice  adapted  to 
present  circumstances  ;  to  interfere  no  farther  than  is  absolutely 
necessary  with  the  general  plan  of  treatment ;  to  assume  no 
future  direction,  unless  it  be  expressly  desired  ;  and,  in  this  last 
case,  to  request  an  immediate  consultation  with  the  practitioner 
previously  employed. 

§  9.  A  wealthy  physician  should  not  give  advice  gratis  to 
the  affluent ;  because  his  doing  so  is  an  injury  to  his  profession- 
al brethren.  The  office  of  a  physician  can  never  be  supported 
as  an  exclusively  beneficent  one ;  and  it  is  defrauding,  in  some 
degree,  the  common  funds  for  its  support,  when  fees  are  dis- 
pensed with,  Avhich  might  justly  be  claimed. 

§  10.  When  a  physician  who  has  been  engaged  to  attend  a 
case  of  midwifery  is  absent,  and  another  is  sent  for,  if  delivery 
is  accomplished  during  the  attendance  of  the  latter,  he  is  entitled 
to  the  fee,  but  should  resign  the  patient  to  the  practitioner  first 
engaged. 

Art.  VI. — Of  differences  between  Physicians. 

§  I.  Diversity  of  opinion,  and  opposition  of  interest,  may, 
in  the  medical,  as  in  other  professions,  sometimes  occasion  con- 
troversy and  even  contention.  Whenever  such  cases  unfortim- 
ately  occur,  and  cannot  be  immediately  terminated,  they  should 


31 

be  referred  to  the  arbitration  of  a  sufficient  niim])er  of  physi- 
cians, or  a  court-?nedical. 

As  peculiar  reserve  must  be  maintained  by  physicians  towards 
the  public,  in  res^ard  to  professional  matters,  and  as  there  exist 
numerous  points  in  medical  ethics  and  etiquette  through  which 
the  feelings  of  medical  men  may  be  painfully  assailed  in  their 
intercourse  with  each  other,  and  which  cannot  be  understood  or 
appreciated  by  general  society,  neither  the  subject  matter  of 
such  differences  nor  the  adjudication  of  the  arbitrators  should 
be  made  public,  as  publicity  in  a  case  of  this  nature  may  be 
personally  injurious  to  the  individuals  concerned,  and  can  hard- 
ly fail  to  bring  discredit  on  the  faculty. 

Art.  YII. —  Of  Pecuniary  Acknowledgements. 
^  1.  Some  general  rules  should  be  adopted  by  the  faculty,  in 
every  town  or  district,  relative  to  pecuniary  acknowledgtiients 
from  their  patients  ;  and  it  should  be  deemed  a  point  of  honor 
to  adhere  to  these  rules  with  as  much  uniformity  as  varying 
circumstances  will  admit. 


CHAPTER  III. 

OF  THE  DUTIES  OF  THE  PROFESSION  TO  THE    PUBLIC,  AND  OF 
THE  OBLIGATIONS  OF  THE  PUBLIC  TO  THE  PROFESSION. 

Art.  I. — Duties  of  the  jyrofessmi  to  the  public. 

^  1.  As  good  citizens,  it  is  the  duty  of  physicians  to  be  ever 
vigilant  for  the  welfare  of  the  community,  and  to  bear  their  part 
in  sustaining  its  institutions  and  burdens :  they  should  also  be 
ever  ready  to  give  counsel  to  the  public  in  relation  to  matters 
especially  appertaining  to  their  profession,  as  on  subjects  of  medi- 
cal police,  public  hygiene,  and  legal  medicine.  It  is  their  pro- 
vince to  enlighten  the  public  in  regard  to  quarantine  regulations ; 
the  location,  arrangement,  and  dietaries  of  hospitals,  asylums, 
schools,  prisons,  and  similar  institutions, — in  relation  to  tlie 
medical  police  of  towns,  as  drainage,  ventilation,  (fee. — and  in 
regard  to  measures  for  the  prevention  of  epidemic  and  conta- 
gious diseases ;  and  when  pestilence  prevails,  it  is  their  duty  to 
face  the  danger,  and  to  continue  their  labors  for  the  alleviation 
of  the  suffering,  even  at  the  jeopardy  of  their  own  lives. 

^  2.  Medical  men  should  also  be  always  ready,  when  called 
on  by  the  legally  constituted  authorities,  to  enlighten  coroner's 
inquest  and  courts  of  justice,  on  subjects  strictly  medical, — such 
as  involve  questions  relating  to  sanity,  legitimacy,  murder  by 
poisons  or  other  violent  means,  and  in  regard  to  the  various 
other  subjects  embraced  in  the  science  of  Medical  Jurisprudence. 
But  in  these  cases,  and  especially  where  they  are  required  to 


make  vH  post-mortem  examination,  it  is  just,  in  consequence  of 
the  time,  labor  and  skill  required,  and  the  responsibility  and 
risk  they  incur,  that  the  public  should  award  them  a  proper 
lionorarium. 

^  3.  There  is  no  profession,  by  the  members  of  which,  elee- 
mosynary services  are  more  liberally  dispensed,  than  the  medi- 
cal, but  justice  requires  that  some  limits  should  be  placed  to  the 
performance  of  such  orood  offices.  Poverty,  professional  brother- 
hood, and  certain  public  duties  referred  to  in  section  1  of  this 
chapter,  should  always  be  recognized  as  presenting  valid  claims 
for  gratuitous  services  ;  but  neither  institutions  endowed  by  the 
public  or  by  rich  individuals,  societies  for  mutual  benefit,  for  the 
insurance  of  lives  or  for  analogous  purposes,  nor  any  profession 
or  occupation,  can  be  admitted  to  possess  such  privilege.  Nor 
can  it  be  justly  expected  of  physicians  to  furnish  certificates  of 
inability  to  serve  on  juries,  to  perform  militia  duty,  or  to  testify 
to  the  state  of  health  of  persons  wishing  to  insure  their  lives, 
obtain  pensions,  or  the  like,  without  a  pecuniary  acknowledg- 
ment. But  to  individuals  in  indigent  circumstances,  such  profes- 
sional services  should  always  be  cheerfully  and  freely  accorded. 

^  4.  It  is  the  duty  of  physicians,  who  are  frequent  witnesses 
of  the  enormities  committed  by  quackery,  and  the  injury  to 
health  and  even  destruction  of  life  caused  by  the  use  of  quack 
medicines,  to  enlighten  the  public  on  these  subjects,  to  expose 
the  injuries  sustained  by  the  unwary  from  the  devices  and  pre- 
tensions of  artful  empirics  and  impostors.  Physicians  ought  to 
use  all  the  influence  which  they  may  possess,  as  professors  in 
Colleges  of  Pharmacy,  and  by  exercising  their  option  in  regard 
to  the  shops  to  which  their  prescriptions  shall  be  sent,  to  dis- 
courage the  druggists  and  apothecaries  from  vending  quack  or 
secret  medicines,  or  from  being  in  any  way  engaged  in  their 
manufacture  and  sale. 

Art.  II. —  Ohligatiofis  of  the  public  to  Physicians. 

^  1.  The  benefits  accruing  to  the  public  directly  and  indirect- 
ly from  the  active  and  unwearied  beneficence  of  the  profession, 
are  so  numerous  and  important,  that  physicians  are  justly  enti- 
tled to  the  utmost  consideration  and  respect  from  the  community. 
The  public  ought  likewise  to  entertain  a  just  appreciation  of 
medical  qualifications; — to  make  a  proper  discrimination  be- 
tween true  science  and  the  assumptions  of  ignorance  and  em- 
piricism,— to  afford  every  encouragement  and  facility  for  the 
acquisition  of  medical  education, — and  no  longer  to  allow  the 
statute  books  to  exhibit  the  anomaly  of  exacting  knowledge  from 
physicians,  under  liability  to  heavy  penalties,  and  of  making 
them  obnoxious  to  punishment  for  resorting  to  the  only  means 
of  obtaining  it. 


